Modifiable psychosocial factors linked to depression among US cancer survivors

Loneliness, functional limitations, and lack of social support were independently associated with depression in a large US-based study of cancer survivors by Philip Baiden from The University of Texas Arlington, US, and colleagues, published October 21, 2026, in the open access journal PLOS One.

Depression among cancer survivors is consistently higher than in the general population, ranging from 20% to 30%. Among survivors, depression can contribute to poorer quality of life, reduced adherence, and higher mortality. While factors such as functional limitations, loneliness, and inadequate social and emotional support have been linked to depression in cancer survivors, studies to date have been small and have typically grouped these factors, making it difficult to tease out the individual contribution of these to depression.

In this study, researchers analyzed data from 70,620 adult cancer survivors who participated in the 2023 and 2024 Behavioral Risk Factor Surveillance System. Among this group, 21.8% reported receiving a diagnosis of depressive disorder at some time in their life.

After adjusting for demographic, socioeconomic, health, and behavioral factors, loneliness emerged as the factor most strongly associated with depression. Those who reported feeling lonely had 2.72 times higher odds of reporting a lifetime diagnosis of depressive disorder than those who did not report loneliness. Functional limitations and lack of social and emotional support were associated with an increased risk of depression (2.05 times and 1.43 times higher, respectively). Physical exercise was associated with a decreased risk of depression.

The study reaffirms the high rate of depression seen among cancer survivors and can help guide screening and interventions to improve mental health outcomes and overall well-being.

Lead author Philip Baiden, Ph.D., an Associate Professor at the University of Texas at Arlington, adds: “Surviving cancer is an important milestone, but it does not mean that the emotional and psychological challenges associated with the disease have ended. Our study of more than 70,000 US cancer survivors found that approximately one in five reported having received a depression diagnosis during their lifetime. These findings remind us that cancer survivorship involves much more than physical recovery. As advances in cancer treatment allow more people to survive the disease, we must pay greater attention to their long-term mental health and overall quality of life.”

“Our findings reinforce the importance of social and emotional support in the lives of cancer survivors. While healthcare providers play an essential role in cancer survivorship, the support survivors receive from family members, friends, and their communities also matters. Cancer survivors should not have to navigate the emotional challenges associated with their diagnosis and recovery in isolation. Strengthening social connections and ensuring that survivors have access to meaningful emotional support should be important considerations in efforts to promote their mental health and well-being.”

“One of the most interesting findings from our research was that loneliness and functional limitations remained strongly associated with depression among cancer survivors even after accounting for demographic, socioeconomic, and health-related characteristics. What stood out to me was the importance of these everyday experiences in understanding the mental health challenges faced by cancer survivors. Our findings suggest that understanding depression in this population requires looking beyond cancer-related medical conditions to consider the social and functional challenges that survivors may experience in their daily lives.”

Co-author Batholomew Chireh, Ph.D., an Assistant Professor at the University of Texas at Rio Grande Valley, adds: “One of the most striking findings from our study was the strong association between loneliness and depression. Cancer survivors who reported feeling lonely had nearly three times the odds of reporting a lifetime diagnosis of depression compared to those who did not feel lonely, even after accounting for demographic, socioeconomic, and health-related factors. This suggests that addressing loneliness should be a priority in efforts to improve the mental health and well-being of cancer survivors.”

Co-author Judith S. Anagbonu, M.S.W., a Ph.D. student at the University of Texas at Arlington, adds: “Our study points to an important opportunity for healthcare providers to improve cancer survivorship care. Routine assessments of loneliness, emotional support, and functional limitations could help identify survivors who may benefit from additional mental health services. Integrating psychosocial screening, counseling, rehabilitation, and community-based support into routine follow-up care may help address some of the challenges survivors face beyond their cancer diagnosis.”

In your coverage, please use this URL to provide access to the freely available article in PLOS One: https://plos.io/4zkAV6S

Citation: Baiden P, Chireh B, Anagbonu JS (2026) Modifiable psychosocial risk factors for depression among cancer survivors in the United States. PLoS One 21(10): e0359599. https://doi.org/10.1371/journal.pone.0359599

Author countries: USA

Funding: The author(s) received no specific funding for this work.